More chest pain for women undergoing PCI with DES

(HealthDay)—Women undergoing percutaneous coronary intervention (PCI) with new generation drug-eluting stents (DES) have a higher prevalence of clinically relevant chest pain, according to a study published online March 2 in JACC: Cardiovascular Interventions.

Marlies M. Kok, M.D., from the Medisch Spectrum Twente in Enschede, Netherlands, and colleagues examined gender differences in chest pain following PCI with newer-generation DES. A patient-level pooled analysis of the TWENTE and DUTCH PEERS randomized trials was performed, involving 3,202 patients (27.2 percent women) who were treated with newer generation permanent polymer-coated DES.

The researchers found that the women were older and had more cardiovascular risk factors: diabetes, hypertension, and positive family history. Women reported more clinically relevant chest pain at one- and two-year follow-up (both P < 0.001). Female gender independently predicted clinically relevant chest pain at one- and two-year follow-up, in multivariate analyses, during daily activities and at minimum physical exertion/at rest (one year: adjusted odds ratios, 1.7 and 1.8; two year: adjusted odds ratios, 1.8 and 1.7, respectively). Both genders had similar two-year rates of death, myocardial infarction, revascularization, stent thrombosis, and various composite clinical end points.

"While the incidence of adverse cardiovascular events was low and similar for both genders, women showed a significantly higher prevalence of clinically relevant chest pain, which might be largely related to mechanisms other than epicardial coronary obstruction," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, some of which supported the TWENTE and DUTCH PEERS trials.

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